Kev Tshawb Fawb Txog Kev Ua Phem Txhaum Cai ntawm Bifidobacteria Ua Ke Nrog Suav Tshuaj Kho Mob Cistanche Ntawm Depreslonand Dementia hauv Cov Neeg Mob Parkinson's Disease Raws Li Lub hlwb-Gut Axis Theory

CAO Nannan. Neurology Department ll, {{0}}ingyang Second People's Hospital,0ingyang City, Gansu Pouince 745000

TSAB NTAWV

Lub Hom Phiaj: 'Nyob rau hauv kev tshawb fawb txog kev tswj xyuas cov teebmeem ntawm bifidobacteria ua ke nrog Suav tshuaj ntsuab tshuaj Cistancheon kev nyuaj siab thiab dementia hauvCov neeg mob Parkinson's disease (PD)thiab cov mechanisms ua tau.

HERB CISTANCHE rau cov neeg mob nrog PARKINSON'S DISEASE (PD)

nyem qhov no kom paub meej ntxiv

Cov txheej txheem; Tag nrho ntawm o112 PD cov neeg mob kho hauv peb lub tsev kho mob txij lub Ib Hlis 2022 txog Lub Ob Hlis 2023 raug xaiv thiab muab faib ua ob pawg, 56 tus neeg mob hauv txhua pab pawg. Pab pawg tswj hwm tau txais kev kho mob niaj hnub, thaum pab pawg sim tau txais bifidobacteria ua ke nrog Cistanche kev kho mob raws li pawg tswj hwm. Cov ntaub ntawv dav dav, cov tsos mob tshwm sim, kev nyuaj siab degree, kev paub txog kev ua haujlwm, ntshav qab zib neurotrophic factor (BN!), cov kab mob plab hnyuv, thiab lwm yam kev ntsuas ntawm cov neeg mob tau soj ntsuam thiab sau tseg. Cov txiaj ntsig; Tom qab kev kho mob, cov tsos mob ntawm ob pab pawg tau txhim kho mus rau qhov sib txawv, tab sis qhov kev txhim kho qib ntawm pawg sim tau ntau dua, thiab tag nrho cov qhab nia thiab txhua qhov qhab nia ntawm Unified Parkinson's disease rating scale (UPDRS) tau qis dua cov ntawm cov. pawg tswj hwm (P<0. 05). The depression degree and cognitive function of the experimental group were also significantly better than those of the control group, and the hamilton depression scale ( HAM!D) score and Montreal cognitive assessment Seale ( MoCA) score were better than those of the control group respectively ( P <0. 05 ). "The serum BDNF level of the experimental group was significantly higher than that the control group ( P <0.05), indicating that the neuroprotective effect was enhanced. The intestinal flora structure of the experimental group also changed favorably, compared with the control group, the proportion of beneficial! bacteria such as bifidobacteria, and lactobacilli decreased, while the proportion of harmful bacteria such as anaerobes, and hydrogen sulfide-producing bacteria decreased ( P <0 . 05). Conclusion: Bifidobacteria combined with Cistanche can effectively improve the motor symptoms, depression degree and cognitive function of Pl patients, and its mechanism may be related to enhancing neuroproteclivelfeet and regulating intestinal flora imbalance. This method provides a new idea and means for the comprehensive treatment of PD.

KEYWORDS: Tus kab mob ParkinsonBifidobacteria Cistanche Brain-gut axis Kev nyuaj siab Dementia

Parkinson tus kab mob (PD)yog ib tug kab mob degenerative ntawm lub paj hlwb nyob rau hauv nruab nrab-hnub nyoog thiab cov neeg laus, tus cwj pwm los ntawm degeneration ntawm dopaminergic neurons nyob rau hauv lub substantia nigra thiab txav tsis meej [1]. Cov neeg mob Parkinson feem ntau nrog cov tsos mob uas tsis yog lub cev muaj zog xws li kev nyuaj siab thiab kev dementia, uas cuam tshuam rau lub neej zoo thiab kev cia siab [2]. Lub pathogenesis ntawm Parkinson tus kab mob tseem tsis tau paub meej, thiab tej zaum nws yuav muaj feem xyuam rau tej yam xws li noob caj noob ces, ib puag ncig, oxidative kev nyuaj siab, mitochondrial tsis ua hauj lwm, protein metabolism tsis meej, thiab neuroinflammation [3]. Nyob rau hauv xyoo tas los no, kev sib raug zoo ntawm plab hnyuv thiab tus kab mob Parkinson tau ntxim nyiam, thiab plab hnyuv flora tsis txaus yuav yog ib qho kev pheej hmoo ntawm tus kab mob Parkinson. Cov kab mob hauv plab yog qhov loj tshaj plaws microecological system hauv tib neeg lub cev thiab ua lub luag haujlwm tseem ceeb hauv tib neeg kev zom zaub mov thiab kev nqus, kev tiv thaiv kab mob, thiab kev sib npaug ntawm cov metabolism. Muaj ib txoj kev sib txuas lus ntawm ob txoj kev sib txuas lus ntawm txoj hnyuv thiab lub hauv nruab nrab lub paj hlwb, uas yog lub hlwb- plab axis. Lub hlwb-lub plab axis xa thiab tswj cov ntaub ntawv los ntawm cov teeb liab molecules xws li neurotransmitters, neurohormones, cytokines, thiab metabolites [4]. Lub plab hnyuv muaj peev xwm cuam tshuam rau cov qauv thiab kev ua haujlwm ntawm lub hauv nruab nrab lub paj hlwb los ntawm lub hlwb-lub plab axis, yog li cuam tshuam rau kev txawj ntse thiab kev xav. Hloov pauv, lub hauv paus paj hlwb kuj tuaj yeem tswj hwm qhov muaj pes tsawg leeg thiab kev ua haujlwm ntawm txoj hnyuv plab los ntawm lub hlwb-lub plab axis tawm tswv yim. Yog li ntawd, lub hlwb-lub plab axis plays lub luag haujlwm tseem ceeb hauv kev tswj hwm cov neuroendocrine-tiv thaiv kev sib npaug ntawm tib neeg lub cev.

Kev cuam tshuam ntawm lub hlwb-lub plab axis tuaj yeem ua rau lub plab zom mov tsis txaus thiab lub hauv nruab nrab lub paj hlwb tsis ua haujlwm, yog li inducing lossis ua rau Parkinson tus kab mob hnyav dua thiab nws cov tsos mob tsis yog lub cev muaj zog [5]. Tam sim no, kev kho mob ntawm Parkinson tus kab mob feem ntau yog ua raws li kev hloov kho dopamine, tab sis raws li tus kab mob loj hlob zuj zus, kev ua tau zoo ntawm cov tshuaj maj mam tsis muaj zog, thiab cov tshuaj tiv thaiv lub cev muaj zog thiab cov teeb meem tsis yog lub cev muaj zog yuav tshwm sim [6]. Yog li ntawd, nws yog ib qho tseem ceeb kom nrhiav tau txoj kev kho kom zoo thiab muaj txiaj ntsig zoo uas tuaj yeem ncua kev loj hlob ntawm Parkinson tus kab mob thiab txhim kho cov tsos mob uas tsis yog lub cev muaj zog. Nyob rau hauv xyoo tas los no, txoj kev kho mob plab hnyuv kab mob tau txais kev saib xyuas ntxiv raws li txoj kev kho mob tshiab. Txoj kev kho mob plab hnyuv loj feem ntau suav nrog probiotics, prebiotics, fecal microbiota hloov pauv, thiab lwm txoj hauv kev. Nws lub hom phiaj yog los tswj qhov sib npaug ntawm lub hlwb-lub plab axis thiab txhim kho cov qauv thiab kev ua haujlwm ntawm lub paj hlwb los ntawm kev txhim kho cov muaj pes tsawg leeg thiab kev ua haujlwm ntawm cov hnyuv. Txoj kev tshawb no tsom los tshawb txog cov kev tswj hwm ntawm Bifidobacterium ua ke nrog cov tshuaj suav tshuaj Cistanche deserticola ntawm kev txhim kho kev nyuaj siab thiab kev dementia hauv cov neeg mob Parkinson's disease.

1 Cov ntaub ntawv thiab cov txheej txheem

1.1 Cov ntaub ntawv dav dav

Tag nrho ntawm 112 tus neeg mob uas muaj tus kab mob Parkinson uas tau kho hauv peb lub tsev kho mob txij lub Ib Hlis 2022 txog Lub Ob Hlis 2023 tau muab faib ua ob pawg, nrog 56 tus neeg mob hauv txhua pab. Tsis muaj qhov sib txawv ntawm cov ntaub ntawv dav dav ntawm ob pawg (P ＞ 0.05), thiab ob pawg tau sib piv, raws li qhia hauv Table 1. Txoj kev tshawb no yog los ntawm cov qauv kev coj ncaj ncees thiab tau txais kev pom zoo los ntawm pawg neeg saib xyuas kev ncaj ncees ntawm peb lub tsev kho mob. Cov ntaub ntawv tso cai tau txais los ntawm cov neeg mob lossis lawv tsev neeg. Cov txheej txheem suav nrog: (1) Ua tau raws li cov txheej txheem kuaj mob Parkinson tus kab mob tsim los ntawm International Parkinson's Disease and Movement Disorders Society (MDS) [7]; (2) Hnub nyoog tshaj 50 xyoo; (3) Kab mob ntawm ntau tshaj 3 xyoos; (4) Hoehn-Yahr theem 2 txog 4; (5) Clinical manifestations lossis kev soj ntsuam cov txiaj ntsig ntawm kev nyuaj siab lossis kev paub tsis meej; (6) Txaus siab koom nrog hauv txoj kev tshawb no thiab kos npe rau daim ntawv tso cai pom zoo. Cov txheej txheem cais tawm: (1) Lwm yam uas cuam tshuam rau cov hnyuv, xws li kev siv tshuaj tua kab mob mus ntev, tshuaj laxatives, tshuaj tiv thaiv kab mob, thiab lwm yam.; (2) Lwm yam kabmob hnyav xws li lub plawv, lub siab, thiab lub raum; (3) Cov poj niam cev xeeb tub los yog lactating poj niam.

Table 1 Sib piv cov ntaub ntawv dav dav ntawm ob pawg neeg mob

1.2 Cov txheej txheem

Pawg tswj hwm tau txais kev kho mob ib txwm muaj, suav nrog cov tshuaj tiv thaiv kab mob Parkinson xws li levodopa thiab dopamine receptor agonists, nrog rau kev txhawb nqa kev puas siab puas ntsws thiab kev cob qhia kev kho mob. Cov pab pawg sim tau kho nrog Bifidobacterium ua ke nrog Suav cov tshuaj Cistanche deserticola raws li pawg tswj hwm. Txoj kev tshwj xeeb yog: kev tswj hwm qhov ncauj ntawm 2 ntsiav tshuaj ntawm Bifidobacterium nyob kab mob capsules (Lizhu Changle) ib hnub, txhua lub tshuaj ntsiav uas muaj 0.5 × 109 CFU ntawm cov kab mob nyob; Kev tswj qhov ncauj ntawm 6g ntawm Cistanche deserticola concentrated tshuaj ib hnub ib zaug. Ob pab pawg tau kho rau 8 lub lis piam.

1.3 Kev soj ntsuam ntsuas

(1) Cov tsos mob ntawm lub cev muaj zog: Unified Parkinson's Disease Rating Scale [8] (UPDRS) tau siv los ntsuas, uas suav nrog plaub ntu: Ntu I yog rau kev coj tus cwj pwm, Ntu II yog rau kev ua neej nyob txhua hnub, Ntu III yog rau kev kuaj xyuas lub cev, thiab Tshooj IV yog rau cov teeb meem tsav tsheb. Qhov qhab nia siab dua, tus kab mob hnyav dua. (2) Qib Kev Nyuaj Siab: Hamilton Depression Rating Scale (HAMD) [9] tau siv los ntsuas, uas suav nrog 17 yam khoom, thiab txhua yam khoom raug muab 0 rau 4 ntsiab lus raws li qhov hnyav. Qhov siab dua tag nrho cov qhab nia, qhov kev nyuaj siab hnyav dua. (3) Kev txawj ntse muaj nuj nqi: Montreal Cognitive Assessment Scale [10] (MoCA) tau siv los ntsuas, uas suav nrog 8 thaj chaw thiab tag nrho ntawm 30 cov ntsiab lus.

Qhov qhab nia siab dua, qhov kev txawj ntse zoo dua. (4) Qib BDNF: Enzyme-linked immunosorbent assay (ELISA) tau siv los kuaj pom, thiab chav tsev yog ng / mL. Qhov siab dua qib BDNF, qhov muaj zog dua cov nyhuv neuroprotective.

(5) Cov kab mob plab hnyuv: Cov kab mob siab heev tau siv los txheeb xyuas cov txheeb ze thiab ntau haiv neeg ntawm cov hnyuv. Qhov sib npaug ntawm txoj hnyuv muaj feem cuam tshuam rau tib neeg kev noj qab haus huv.

1. 4 Cov txheej txheem txheeb cais

Cov ntaub ntawv raug txheeb xyuas siv SPSS 26.0 software. Cov ntaub ntawv ntau tau qhia raws li (x ± s) thiab t-test tau ua; cov ntaub ntawv enumeration tau qhia raws li zaus los yog feem pua ​​(n lossis %) thiab qhov kev xeem χ2 tau ua. P < 0.05 qhia tias qhov sib txawv yog qhov tseem ceeb.